The enhancement of beneficial effects following audio feedback by cognitive preparation in the treatment of social anxiety: A single-session experiment

Background and objectives: According to cognitive models, negatively biased processing of the publicly observable self is an important aspect of social phobia; if this is true, effective methods for producing corrective feedback concerning the public self should be strived for. Video feedback is proven effective, but since one’s voice represents another aspect of the self, audio feedback should produce equivalent results. This is the first study to assess the enhancement of audio feedback by cognitive preparation in a single-session randomized controlled experiment.MethodForty socially anxious participants were asked to give a speech, then to listen to and evaluate a taped recording of their performance. Half of the sample was given cognitive preparation prior to the audio feedback and the remainder received audio feedback only. Cognitive preparation involved asking participants to (1) predict in detail what they would hear on the audiotape, (2) form an image of themselves giving the speech and (3) listen to the audio recording as though they were listening to a stranger. To assess generalization effects all participants were asked to give a second speech.ResultsAudio feedback with cognitive preparation was shown to produce less negative ratings after the first speech, and effects generalized to the evaluation of the second speech. More positive speech evaluations were associated with corresponding reductions of state anxiety. Social anxiety as indexed by the Implicit Association Test was reduced in participants given cognitive preparation.LimitationsSmall sample size; analogue study.ConclusionAudio feedback with cognitive preparation may be utilized as a treatment intervention for social phobia.

► We compared audio feedback with cognitive preparation (AF–CP) and without (AF-only).
► AF–CP showed enhanced effect on socially anxious individual’s voice evaluation. AF–CP showed enhanced effects on explicit and implicit measures of social anxiety.
► Effects of AF–CP generalized to a second social task.